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Ernst A. Rodin, MD; Garcia DeSousa, MD; Dan Haidukewych, PhD; Rashid Lodhi, MS; Richard C. Berchou, PharmD

Arch Neurol. 1981;38(4):240-242.

Abstract
• A dissociation of free vs bound phenytoin levels is frequently observed in the presence of therapeutic doses of valproate sodium. This leads at times to symptoms and signs of phenytoin intoxication despite "therapeutic" plasma levels. The importance of supplementing bound levels with free levels is stressed when combined therapy of this type is used in epileptic patients.

Author Affiliations
From the Lafayette Clinic (Drs Rodin and Berchou and Mr Lodhi); the Epilepsy Center of Michigan (Drs Rodin and Haidukewych); and the Departments of Neurology (Drs Rodin and DeSousa) and Pharmacy (Dr Berchou), Wayne State University, Detroit.

Footnotes
Accepted for publication May 12, 1980.

Reprint requests to Epilepsy Center of Michigan, 3800 Woodward, Seventh Floor, Detroit, MI 48201 (Dr Rodin).